Healthcare Provider Details

I. General information

NPI: 1215099056
Provider Name (Legal Business Name): PMC MARKETING CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVE SABANA SECA INT DEL CARMEN LEVITTOWN
TOA BAJA PR
00949
US

IV. Provider business mailing address

PO BOX 29166
SAN JUAN PR
00929-0166
US

V. Phone/Fax

Practice location:
  • Phone: 787-795-1030
  • Fax: 787-795-1033
Mailing address:
  • Phone: 787-641-3888
  • Fax: 787-756-0160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. SULTAN SALEH YASSIN
Title or Position: VICE PRESIDENT
Credential: PHARM D
Phone: 787-641-3888